A sore back or poor performance because of back pain is a very common complaint, however, can be very difficult to diagnose.
The signs of back pain include stiffness in walk or trot, resentment of being saddled, reduced performance or inability or refusing to jump, head-shaking, tail-swishing, and altered behaviour.
Examination of a horse exhibiting back pain will include the following steps:
1. Examination at rest
We will evaluate the horse’s conformation, evidence of any muscle wastage, symmetry of the hindquarters and how squarely the horse stands.
2. Examination at move
The horses move will be evaluated on the straight line (walk and trot) and on the lunge. In some cases of subtle problems we may ask you to ride the horse, as well. Many horses with back pain will show a restricted hindlimb action with poor hock flexion and a tendency to drag the toes. The horse may have either a close (plating) or wide (straddling) gait behind. Flexion test may be carried out to rule out common hind limbs lameness due to bone spavin.
3. Static palpation
By gently palpating the muscle along the back, areas of pain or muscle spasm may be found.
4. Mobile palpation
As we have further training in animal chiropractic techniques, we are perform mobile palpation of the spine identifying any restrictions that may be present. Treatment is then carried out at the same time via quick adjustment, restoring the normal movement of the affected joint.
In some cases we may decide radiography of the spine may be necessary. Our portable machine is efficient enough to perform radiography of the Dorsal Spinous Processes (i.e. to identify Kissing spine lesions). For images of the facets joints, a mounted high power x-ray machines are necessary, therefore we would have to refer you to one of the referral practices we collaborate with.
6. Local analgesia
In cases of kissing spine lesions identified by radiography, we would need to confirm the clinical significance of these lesions by injecting a local anaesthetic around the lesion (as not all radiographic changes are causing pain). Local analgesia is also useful in diagnosis sacroiliac joint disorders.
Ultrasound is most useful to diagnose lesions of the soft tissues of the back such as desmitis (strain) of the supraspinous ligament. Although the ultrasound cannot penetrate through bone, it gives an accurate picture of the surface of bone and so can also be dry useful to diagnose facet joint arthritis and abnormal, strained attachments of ligaments onto bone (enthesiopathy).
8. Bone scanning
In some cases even the most thorough clinical examination will not be enough to reach the diagnosis, and we may wish to refer you for a bone scan. During this procedure, a radio-labelled isotope is injected intravenously into your horse. The isotope is drawn to a bone with active remodelling process. This radioactivity is then detected by a gamma camera and the active sites of bone metabolism show up as ‘hot spots’. Further diagnostics (radiography, ultrasonography, local analgesia) will be used to follow up on these hot spots to reach the diagnosis.
Majority of horses will respond to conservative therapies (i.e. chiropractic or osteopathy for spinal joint restrictions, or physiotherapy or laser treatment for muscle originating back pain). Some cases may also benefit from added pain relief (either systemic in form of NSAIDs, or locally injected steroids). The treatment options are very much depending on particular horse and diagnosis so you would be advised of appropriate treatment at the end of the examination.
Please refer to our chiropractic website for more information on chiropractic care and examples of real cases before and after the treatment.